Unknown Individual – Psychiatry Physician, NPI 1497813471

Unknown Individual is a healthcare provider. based in Dearborn, Michigan. specializing in Psychiatry Physician. They hold a License No. 4301082590 (MI). The NPI Number for Unknown Individual is 1497813471

Main info

Organization
Inactive
19 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1497813471
Phone
(313) 562-6633
Address
2314 MONROE ST
Deactivation Date
19 April 2021

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2007 (19 years ago)
PAC ID
7911004213
Professional Enrollment ID
I20070522000205
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2314, Monroe Street, Southwestern Outer Drive, Dearborn, Wayne County, Michigan, 48124, United States

    DEARBORN, MI 481243045

    Phone: (313) 562-6633

    Fax: (313) 562-0880

    Type: Location

  • 10411, Mortenview Drive, Taraban's Sub, Taylor, Wayne County, Michigan, 48180, United States

    TAYLOR, MI 481803775

    Phone: (313) 299-1005

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48124)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1497813471 for Unknown Individual, then check state licensing separately.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Dearborn, Michigan; more addresses can appear in NPPES.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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